The  Relationship Between Academic Stress Levels and Sleep Quality Among Health Sciences Students

Helmi Rizal Helmi; Eka Handayani Oktharina; Angela Klau

doi:10.70716/mohr.v4i3.733

Authors

Helmi Rizal Helmi Prodi Kedokteran Dasar, Fakultas Kedokteran, Universitas Gunadarma, Depok, Indonesia
Eka Handayani Oktharina Prodi Biologi Kedokteran, Fakultas Kedokteran, Universitas Sriwijaya, Palembang, Indonesia
Angela Klau Ilmu Kesehatan, Fakultas Keperawatan, Instituto Suporior Cristal, Polo Aileu, Timor Leste

DOI:

https://doi.org/10.70716/mohr.v4i3.733

Keywords:

Academic stress, Sleep quality, Health sciences students, Systematic literature review, PRISMA 2020

Abstract

Academic stress and poor sleep quality are increasingly common among health sciences students due to intensive academic workloads, clinical training, and continuous performance evaluations. These conditions adversely affect psychological well-being, learning capacity, and academic performance. This study synthesized recent evidence on the relationship between academic stress and sleep quality through a Systematic Literature Review (SLR) in accordance with the PRISMA 2020 guidelines. Literature searches were conducted in Scopus, PubMed, ScienceDirect, and Google Scholar for studies published between 2020 and 2026. Of 322 identified records, 22 studies met the inclusion criteria and were included in the qualitative synthesis. The findings consistently showed that higher academic stress was associated with poorer sleep quality, including shorter sleep duration, longer sleep latency, frequent nocturnal awakenings, and greater daytime dysfunction. Major stressors included academic workload, examinations, clinical practice, and poor time management, while irregular sleep schedules, excessive screen time, and caffeine consumption further worsened sleep quality. These findings highlight the need for integrated stress management, sleep hygiene education, and mental health support programs to improve students' well-being and academic success.

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References

Alhamed, A. A. (2023). The link among academic stress, sleep disturbances, depressive symptoms, academic performance, and the moderating role of resourcefulness in health professions students during the COVID-19 pandemic. Journal of Professional Nursing, 46, 83–91. https://doi.org/10.1016/j.profnurs.2023.02.010

Allende-Rayme, F. R., Acuña-Vila, J. H., Correa-López, L. E., & De La Cruz-Vargas, J. A. (2022). Academic stress and sleep quality during the COVID-19 pandemic among medical students from a university in Peru. Revista de La Facultad de Medicina, 70(3), e93475. https://doi.org/10.15446/revfacmed.v70n3.93475

Alotaibi, A. D., Alosaimi, F. M., Alajlan, A. A., & Abdulrahman, K. A. Bin. (2020). The relationship between sleep quality, stress, and academic performance among medical students. Journal of Family and Community Medicine, 27(1), 23–28. https://doi.org/10.4103/jfcm.JFCM_132_19

Alwhaibi, M., & Al Aloola, N. A. (2023). Associations between stress, anxiety, depression and sleep quality among healthcare students. Journal of Clinical Medicine, 12(13), 4340. https://doi.org/10.3390/jcm12134340

Arzani-Birgani, A., Zarei, J., Favaregh, L., & Ghanaatiyan, E. (2021). Internet addiction, mental health, and sleep quality in students of medical sciences, Iran: A cross-sectional study. Journal of Education and Health Promotion, 10(1), 409. https://doi.org/10.4103/jehp.jehp_1506_20

Aydin, F., & Aydin, A. (2024). Relationship among sleep quality, quality of life and academic self-efficacy of university students. Current Psychology, 43(24), 21110–21119. https://doi.org/10.1007/s12144-024-05929-2

Bayoumy, H. M. M., Sedek, H., Omar, H., & Ayman, S. (2023). Investigating the relationship of sleep quality and psychological factors among health professions students. International Journal of Africa Nursing Sciences, 19, 100581.

Benítez-Agudelo, J. C., Restrepo, D., Navarro-Jimenez, E., & Clemente-Suárez, V. J. (2025). Longitudinal effects of stress in an academic context on psychological well-being, physiological markers, health behaviors, and academic performance in university students. BMC Psychology, 13(1). https://doi.org/10.1186/s40359-025-03041-z

Bloomfield, L. S. P., Fudolig, M. I., Kim, J., Llorin, J., Lovato, J. L., McGinnis, E. W., McGinnis, R. S., Price, M., Ricketts, T. H., Dodds, P. S., Stanton, K., & Danforth, C. M. (2024). Predicting stress in first-year college students using sleep data from wearable devices. PLOS Digital Health, 3(4). https://doi.org/10.1371/journal.pdig.0000473

Brown, J. K., & Papp, L. M. (2024). COVID-19 pandemic effects on trajectories of college students’ stress, coping, and sleep quality: A four-year longitudinal analysis. Stress and Health, 40(2). https://doi.org/10.1002/smi.3320

Busa, F., Csima, M. P., Márton, J. A., Rozmann, N., Pandur, A. A., Ferkai, L. A., Deutsch, K., Kovács, Á., & Sipos, D. (2023). Sleep Quality and Perceived Stress among Health Science Students during Online Education—A Single Institution Study. Healthcare, 12(1), 75. https://doi.org/10.3390/healthcare12010075.

Cheng, R., Yang, L., & Kang, S.-J. (2025). A study on the relationship between high school students’ sleep quality, physical exercise, academic stress, and subjective well-being. BMC Psychology, 13(1), 180. https://doi.org/10.1186/s40359-025-02497-3

de Casteele, M., Soenens, B., Campbell, R., Ponnet, K., Vermote, B., & Vansteenkiste, M. (2025). Too Pressured to Sleep? Exploring the Role of Study Motivation, Test Anxiety and Procrastination in University Students’ Sleep Patterns During Exam Periods. Stress and Health, 41(3), e70040. https://doi.org/10.1002/smi.70040

Ghoul, Z., Pernice, F. M., Branson, J. S., & Lumley, M. A. (2025). The impact of a remote, brief, sleep hygiene intervention on undergraduate students’ sleep and stress: A randomized controlled trial. Journal of American College Health. https://doi.org/10.1080/07448481.2025.2464762

Huang, X., Wen, Y., Li, Y., & Luo, X. (2024). Association of perceived stress and sleep quality among medical students: The mediating role of anxiety and depression symptoms during COVID-19. Frontiers in Psychiatry, 15, 1272486. https://doi.org/10.3389/fpsyt.2024.1272486

Jowkar, Z., Fattah, Z., Khorshidi Asl, Z., & Hamidi, S. A. (2022). Stress, sleep quality, and academic performance among dental students in Shiraz, Iran. International Journal of Dentistry, 2022(1), 3781324. https://doi.org/10.1155/2022/3781324

Li, M., Jin, X.-Y., Li, H., Chu, M.-D., & Su, Z.-F. (2025). Sleep quality and its correlates among medical undergraduates in Anhui Province: a cross-sectional study on academic stress, mental health, and lifestyle factors. Sleep Epidemiology, 5, 100109. https://doi.org/10.1016/j.sleepe.2025.100109

Lukowski, A. F., Karayianis, K. A., Kamliot, D. Z., & Tsukerman, D. (2024). Undergraduate student stress, sleep, and health before and during the COVID-19 pandemic. Behavioral Medicine, 50(1), 1–15. https://doi.org/10.1080/08964289.2022.2085651

Medikonda, J. (2023). A clinical and technical methodological review on stress detection and sleep quality prediction in an academic environment. Computer Methods and Programs in Biomedicine, 235, 107521. https://doi.org/10.1016/j.cmpb.2023.107521

Razaq, R., Babar, E., Sajjad, R., Yousaf, Q., & Mahmood, T. (2024). Association of stress and sleep quality among the health sciences students: An analytical study. Foundation University Journal of Rehabilitation Sciences, 4(1), 52–57.

Salazar-Granizo, Y. E., Hueso-Montoro, C., & Caparros-Gonzalez, R. A. (2024). Lifestyles and Academic Stress in University Students of Health Sciences: A Mixed-Methodology Study. Healthcare, 12(14), 1384. https://doi.org/10.3390/healthcare12141384

Souza, A. P. de, Murgo, C. S., & Barros, L. de O. (2021). Academic adaptation in university students: Associations with stress and sleep quality. Psicologia: Teoria e Prática, 23(3), 1–21. https://doi.org/10.5935/1980-6906/ePTPPA13275

Toubasi, A. A., Khraisat, B. R., AbuAnzeh, R. B., & Kalbouneh, H. M. (2022). A cross sectional study: The association between sleeping quality and stress among second and third medical students at the University of Jordan. The International Journal of Psychiatry in Medicine, 57(2), 134–152. https://doi.org/10.1177/00912174211011287

Zang, W., Liu, N., Wu, J., Wu, J., Guo, B., Xiao, N., Fang, M., Liu, Z., Zhang, Y., Wei, X., Zhang, Z., Zhang, Q., & Mao, X. (2025). From Quality of Life to Sleep Quality in Chinese College Students: Stress and Anxiety as Sequential Mediators with Nonlinear Effects via Machine Learning. Journal of Affective Disorders, 389, 119679. https://doi.org/10.1016/j.jad.2025.119679

Zhao, C., & Zhang, Y. (2024). Moderated serial mediation effects of adaptation problems, academic stress, and interpersonal relationships on the sleep quality of early-year university students. Frontiers in Public Health, 12, 1476020. https://doi.org/10.3389/fpubh.2024.1476020